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PRE 2010 DOCSCity of Fridley, BUILDING PERMIT N° 5 " o Date:_-_ Owner: $udder Address Address _ LO TION BU I ILDING No. - Street �y`,� ._i Pari of Lot Lot _Block . ...._ Addition or Sub -Division _ ' . `-" Corner Lot __ _ _. Inside Lot _ _ __. Setback Si Sewer Elevation _ __ _ . _ Foundation Elevation _. --• ----- DESCRIPTION OF BUILDING To4U Used .� �r &) Front Depth- Height Sq. Ft. 4 Cu. Ft. Fro : Depth _, H ght _ _!, Sq. Ft. _ Cu. Ft. Type of Construction�i Est. Cost __-To be Completed In consideration of the issuance to me of a permit to construct the building described above, Ido do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings, within the city limits and this permit may be revoked at any time_upog viola any of the provisions of said ordinances.` 1 ' Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, Sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder L&J",( Address Address LOCATION OF BUILDING No. �( Street Part of Lot Y Lot Block ,�_./ Addition or Subdivision Corner Lot Inside Lot t::::Setback T' side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: cam- i --t J' T Front Depth Height Sq. Ft. Cu. Ft• Front epth Height sq. Ft. Cu. Ft.— Type t. Type of Construction Estimated Cost To be.Completed The undersigned hereby.makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATEl Cc ` CL F �) .. .�. _ sIGNATURE (schedule of Fee Costs can be found on the Reverse side). ., HOUSE HEATING -.TEST RECORD ADDRESS APT. - FLOOR ` CITY SUBURB i OCCUPANT ') 0 - OWNER HEAT LOSS. nATEOTG. INST. GAS CO. METER BADGE # SOLD BY 0 INSTALLED BY Electrical Work By i i -` ;.Gas Line By ' �O TYPE OF HEAT ' 'GA FA HW STEAM Sk-CE HTR. S NIT HTR. OTHER CONVERSION MAKE ? BURNER Model '` Max. 46 Rating MAKE t3F_ FURNACE Model',;, •, CONTROLS THERMOSTATS r ^' "`I Nodi Plug Vent Size _ -- Volvo KIND COLINER SIZE NONE Limit Draft Hd Regularor Limit Setting Filters -J; Size ►dumber Fan Setting Chimnei'`Location Inside Outside Pilot Type ``yam' ChimnejLonstruction Pilot Make Pilot Model Smoke mb Wiring Pilot Timing w Draft Test Tog L.W. Cut Off Door .Pr ' sure Lighting Inst. Pressure Percent CO2 Date Tested Input CFH fx " Percent 02 Comparyr`Testing Stock Temp. — Percent GO Name of. Tester Form 235 Application for Power Plants and Heating. Cooling. Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell; & Duct Work ........................7� i 8.00 $ Replacement of Furnace 5.00 Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... .2.50 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ _ Replacement of Furnace .............................. §.00 Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 ................ 2.50 $ STEAM or HOT WATER SYSTEM ° Furnace Shell & Lines—to 400 sq. ft. EDR Steam- ...... 8.00 $ j Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ t Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ g GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ /, 5� Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH— OUGH FINAL— FINAL Dept. of Bldgs. Phone SU. 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn— , 11 inn — "�p .4 16 Owner Kind of Building . 1/7 Used as To be completed about Estimated Cost, $ j Old—New. Building Permit No. \� (9� Permit No. DESCRIPTION OF WORK HEATING HEATING or POWER PLANTS—Steam, Hot Water, Warm Air No. Trade NameSize Capacity Sq. Ft. E.D.R l/ BTU H.P. Total Connected Load 5 Kind of Fuel BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. (REMARKS -OVER) Signed W_ t » D -56-/ s HEAT LOSS CALCULATIONS Weatherstrips A.S.H.V.E, Guide ows epnrs Reference s No I Yes No 19— F1.I Room I Length DEPARTMENT OF BUILDINGS , MINN. Construction No. Insulation t. Wall Int. Wall Ceiling RoofFloor Kind How. Applied Width Height I I FII Room Length Y,4,4'- Width /a-' Height Windows and Doors—Crackage and Area Doors- rackage nd Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. Width Height No. of Lineal A . Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of a e lights of crack sq. ft© 1110 d1 G Am / o /0. A No. of ® /1, / / Coef.1 Btu Infiltration Exp. wall &7Net / IQ Exp. wall of I 64-9 Glass Exp. wall Net exp. wall Ceiling ja 0 A096) Exp. wall Q Ceiling' A 144 I j) Net exp. wall / (� Ceiling Floor Int. wall Ceiling Floor' / Win ows an Doors- rackage nd Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. IRS Width Height No. of Lineal ft. Area No. of pane of a e lights of crack sq. ft© Width c No. of Coef.1 Btu Infiltration '" Coef. B u Infiltration Glass // A' Exp. wall &7Net / IQ Exp. wall Exp. wall 64-9 Int. wall Exp. wall Net exp. wall Ceiling ja /(' 1 A096) Int. wall Q Ceiling' Int. wall Ceiling Floor j) Q / (� Ceiling Floor Total Btu. Required sq.D.R. or sq. ins. W.A. Leader area tm 9C Fd im_ oom I Length Width IT Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. IRS Windows and Doors—Crackage and Area Width Haight No. of Coef.1 Btu Infiltration '" lights Glass , // A' Exp. wall &7Net / Glass exp. wall Exp. wall 64-9 Int. wall Exp. wall Net exp. wall Ceiling 1 /® / /o Floor Total Btu. / Requ'%ted sq. ft. E.D.R. or sq. ins. W.A. Leader area Coef. Btu Infiltration Glass l Exp. wall Net exp. wall / /(9 /,0140 Int. wall Ceiling %® 175-0 Floor Total Btu. Require sq. .R. or sq. ins. W.A. Leader area x try t? -W i D......,. t i ---.1, / 141;.7,.1. 74o;.ht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights opt crrackj sq. ft. Windows and Doors—Crackage and Area Width Haight No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. // A' Glass / Coef. Btu Infiltration Glass l Exp. wall Net exp. wall / /(9 /,0140 Int. wall Ceiling %® 175-0 Floor Total Btu. Require sq. .R. or sq. ins. W.A. Leader area x try t? -W i D......,. t i ---.1, / 141;.7,.1. 74o;.ht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights opt crrackj sq. ft. 1=0 Coef. Btu Infiltration / // A' Glass / Glass Exp. wall o Exp. wall Net exp. wall /' / 1 /® / /o Int. wall Q Ceiling' Int. wall j) Floor Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /FI_1 1, Rnnm I Length 4 Width Height " Windows and Doors—Crackag and Area Width Height No. of Lineal ft. Area N of pane of pane lights of crack sq. ft. 1=0 Coef.. Btu Infiltration Glass l® o Exp. wall , Net exp. wall Q Int. wall Ceiling Floor Total Btu. Reguired sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley Apprcation for Plumbing and Gas Fitting Permit Dep:. of Bldgs. Phone SII 4-7470 r DESCRIPTION OF WORK 1117�9-1<111R _� Number, Kind and Location of Fixtures Location G7 NO. RATE TOTAL Number Fixtures .................. x $1.50 N Future Fixture Opening ................ = Y' o� � p Z Z W x 3.25 W Z • $ -1S = 6 WATER HTR. GAS ELEG Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st d 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer s� Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .................. x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... �Z x 2.00 $ -1S = 6 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...........$ ®/1 TOTAL FEE , City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, .Min„°! - Owner ✓�'' `� Kind of Building Used as To be completed about Estimated Cost, $ G /� Ol Ne Building Permit Permit No. 0 Signe P� �a By Business Phone No ROUGH .1 " a 3 - 6A FINAL City of Fridley, Minn. BUILDING PERMIT .0. James J. Bernstein Builder Same i . 1 1 .. 1 WINW1m_ ..77' . II N° 10446 LOCATION OF BUILDING No. __ 5849 Street Washington St. part of Lot Lot 14 Block 1 Addition or Sub -Division . Lynda 1 e B 1 de r s 7th Addn . Corner Lot — Inside Lot _ Setback Sewer Elevation Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: G a r a g e . Front 2 4 1 Depth 241 Height 101 Sq. Ft. 5 7 6 Cu. Ft. 5760 Front 760 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction _ _ F a m e Est. cost — $ 2 . 0 0 Q - 0.0.__.. To be Completed Surfaced driveway required. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinanoea of the city of Fridley. on _ In consideration of the payment of a fee of $ 9 - 0 0 , permit is hereby granted to Jam p c J Bernstein to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair andmoving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector Hank Muh'ch NOTICE: This permit does not cover the construction, installation for wiring, phnubing, gas heating, sewer or water. Be aro to we the Building Inspector for separate permits for these hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDDLEY, MINNESOTA OWNEEi IS NAME // BUILDER / f LOCATION OF BUILDING NO. SOLI STREET / = LOT I BLOCK � ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDEYARD 3� SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front Depth !�y / Height !® Square feet Cubic Feet r7ale Front Depth Height Square feet Cubic Feet Type of Construction ��Z-sL^�v� Estimated Cost 2, e9fo To Be Completed Ov-Z, /, The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATEOff? 9' SIGNATURES (Schedule of Fee Costs can be fouSon the Reverse Side.) BUILDING PERMIT"FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing structure or building,.or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: Uniform Building Code: Type 1, 2, & 4 - $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.50 for each one thousand cubic feet. For the purpose of computing fees for building permits, the cubical contents of any 'building "aY"-addition to a uniform height 'throughout ty multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average height.of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. NSSSD Connection Charges based on location - Area 1 or 2. 53-84-5915.51 Application for power Plants and Heating. Cooling. Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL 1st 3 Fixtures ...................... Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ Gas Space Heater 1 yPIW AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule 7.01) VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL // - / D - 00 Dept. of Bldgs. Phone SU 4 -7470 - Location 5849 N E Washington St City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, M4-14-70inn 19 _ Owner James Berstein Kind of Building Used as To be completed about res 4-19-70 Estimated Cost, $ 10.00 Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Warm Morning Space Heater Trade Name Size No Capacity. Sq. Ft. E.D.R BTU 20,000 H.P. Total Connected Load Rind of Fuel Gas G BURNER — Trade Name Size No_ Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) By A�0A OLIS GAS CO. . 42 211A Business Phone No a SUBJECT PERMI13744 City of Fridley AT THE TOP OF THE TWINS PERMIT r i. BUILDING R EMIPT N0. i ___ COMMUNITY DEVELOPMENT DIV. Ly _ �_, PROTECTIVE INSPECTION,SEC. e,3 �� 0, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY I.J 612-560-3450 910-F15 9/9/76 JOB ADDRESS 5849 Washington Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 Lyndale Builders 7th Addn. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Jim Bernstein 5849 Washington Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. D. W. Harstad Co., Inc. 7101 Hwy. #65 N.E., Fridley, Mn. 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Xf] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 8' x 14'8" Dining Room Addition to Dwelling Finish work to be done by owner 9 CHANGE of USE FROM TO STIPULATIONS provide 22" x 30" attic access or connect to existing attic space. Provide drawing of addition location on existing house. NOW rocal urri TELDWON'�+� ECiRIC - GAS RFQUIREI) �Y LA PERMITS REQUURED W1NG, ��A1�G►, PL�It�� l4#� 5t�l��i, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 118 1180 ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I .HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,495 $2.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST UCTION R THE PERFORMANCE OF CONSTRUCTION. $17.95 None -�� PLAN CHECK FEE TOTAL FEE 20.45 SIGNATURE OFC , RACTOR OR AUTHORIZED GENT ( ATE) WHEN PROPERLY VALIDATED THIS IS �2. L� BLDG INSP `YOO�UR/'}PERMIIT - i -%-`n, DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) a vi E i ur rniuj r -i APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT i OWNER'S NME : &4e�--5 ��i e / BUILDER: 6 5 7Q0 co we ADDRESS: Sg� rV C1,4,5111 IK 5406- ADDRESS: ae/ NO:. STREET: f, LOT: BLOCK: ® ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: N• Depth: /y" Height: / Square Feet: ®$ Cubic Feet: 1 Q Front: Depth: Height: 0 r Square Feet; Cubic Feet: Type of Construction: CJ U P 7 n: Estimated Cost: $ _ To Be Completed: — The undersigned hereby makes application for a permit for the Mork herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. i ODATE: SIGNATURE: (See R erse Side For Additional Information.) CPO 3,f-, �76 .S7-/YPQ,4-At7 40 -*v S o o a[ de -e-2 .,x 30 4rric. 116 E k( S r. ,j F. 4 -rt -r L 5,A 4-c -C W4 uu,O� �4 pIT<d Z ---,d 7-1 ly ---4 d AJ BUILDING PERMIT FEE SCHEDULE SECTION 2. The.Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and -in the manner herein provided to -wit: TEw CONSTRLcT]CQI3: Single family Homes and Garages: $4.00/1000 cubic feet PLAN CHECK: 25 percent of building permit fee. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights. of the upper surface or to the average.e height of the roof`su.rface of the main gable of a pitched roof. f For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no,,case shall the fee charged for any permit as set forth in Section 2 be less tl an_,..,$7.50. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CF,RT.IFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OW14ER: � �- F'_ - a DATE SITE ADDRESS: 1-�;-mss• , p-,= _ , PHONE: CONTRACTOR: k 6!/ . Page 1 of 4 4 1 Determine working square footage of each 1. Total exposed wall area...... 31�'JeO/ sq. ft. x .17 2. Toal roof/ceiling area ...... sq. ft. x .05 Total exposed wall area above floor = 2 3,L a. Total wall window area ................................. b. Total door area...................................... 7,Z c. Total sliding glass door area ......................... d. Total fireplace wall area........................... o. e. Total wall framing area (average 10%) .............. .. f. Total rim joist area g. wall area above floor. ..... o ........ ........ ?.'- r h. wall area above floor .......................... i. wall area above floor..... ..... o- ... o ...... o. •j. wall area above floor... ..................... Total exposed foundation area = z/1). & k. Total foundation window area ....................:...... 1. Total net foundation area above grade ................. Determine "U" value of each wall segment (e.g. window, door, each separate wall section) a.17,:2 7 . X b. / 7 - X C. X d. X e . � -- X f. �d`7 �® X g. _cp-c�-/• X olull *lull _ -i--!/ 117711 = 117711 = 117711 _ ll 0s, "u�t$ � 0a h. X ttu" _ i. X "U11 = j - X foul* k. X �(J, X 117711. _ If item #3 is the same as, or less than item #1, you' have met the intent of SBC 6006 (c) 2. loull 3 . ............................. Total = .. -Exterior Envelope Average IIUt1 Computation Total exposed roof/ceiling area m. Total skylight area n. Total roof/ceiling framing area .(average 10%).. o. Total net insulated roof/ceiling area.......... ®� Determine "U" value for each roof/ceiling segment Page 2 of 4 M. -71-- X 11*T1/ _ n. Aon- X "U1/ O. X IIUI/ t 0_3 lt 'A 4 ........................... Total _ o If total of #4 is the same as, or less than #2, you have me the intent of SBC 6006 (c) 1. Alternate Building Envelope Design TO utilize the total envelope system method, the values established by the sum.of items #3 and #4 shall not be greater than the sum of items #1 and #2. to a + 2. _ 3. + 4. _ WALL SECTIONS j NOTE: Use 10% of opaque wall area.for frame construction MM WALL Page 3 of 4. Construction 1. Interior air film R -Value 0.68 air film 0.68. 2. FIG. #4 3. O 4. 511-16 5. NOT?,: Indicate 5. �® 6. Exterior air f ilm 0.17 air film 0.17 Total 1. Interior air film 0.68 2. 3. 4. 5. X 6. Exterior air film 0.17 Total 1, Interior air film 0.68. 2. FIG. #4 3. O 4. NOT?,: Indicate 5. �® 5® C� 6. Exterior air film 0.17 Total //6-L- 1. Interior air film 0.68 2. 3. C ®eco c Se. L- /101 4. 5. 6. Exterior air.film 0.17 Total .7113 I d r a FIG. #4 Ir O NOT?,: Indicate type, "R" 'value, depth and placement of insulation. ROOF/CEILING Vented FIG. #5 J. `./ .. Heat flow up Heat flovy up . ;•vented •FI -G. #6'.. 0 1 -' 1 =✓ -�f • N0�—VL'1�'TED • . Heat flow up PPG. 07 ' Page 4 of 4 Construction R -Value 1. Interior air film 0.61 2• . r°4 ft J"K 3. `! ."11 4. Exterior air film (still) 0.61 Total "30(-'eso 1. Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total 1. Inside air film 0.61 2. 3. 4. 5. Outside air film 0.17 Total Note: Use additional sheets if more space is needed for details and calculations PERMIT NO. City of Fridley o 18594SUBJECT AT THE TOP OF THE TWINS BUILDING _ PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. I INSPECTION SEC. y� 7 r 1 � PROTECTIVE I i = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/13/86 JOB ADDRESS 5849 Washington Street N.E. 1 LEGAL LOT NO. 14 BLOCK 1 TRACT OR ADDITION SEE ATTACHED Lyndale Builders 7th Addition DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Bernstein 5849 Washington Street N.E. 571-0623 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Res.idential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR CI MOVE ❑ REMOVE 8 DESCRIBE WORK Relocate detached garage to be 141 further back on lot 9 CHANGE OF USE FROM TO STIPULATIONS Tie slab extension into existing slab with dowels. Provide a hard surface driveway. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $600 �50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $15.50 SIGNATURE FCONT RACTOR OR AUTHORIZED AGENT IDATEIWHEN PF OPERL`� VALIDATED THIS IS YOUR PERMIT ✓ 2 >✓i + rv� '+ 2/z C 1c BLDG )NSP A i Ji NEW [ ] ADDN. [ ] ALTER. [ ] Construction Addre Legal Description: -�-- Owner Name & Address: : � Contractor: Address: City of Fridley Effective 4/1/86 �R-1 AND R-2 Building Permit Application Attach to this application, a Certificate of Survey of the of with t/4 proposed construe/tion ra n RA it to scale. ` DESCRIPTION 0 IMPROVEMENT Tel. # Tel. # z- LIVING AREA: Length 1'/ Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ,::) Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback 46!Type of Construction: � � EEstimated Cost: $ Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: �� _(5 APPLICANT: � ' Tel . # , ✓ 0 CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ J'Sa Fee Schedule on Reverse Side $ -tea 25% of Building Permit Fee $ $•50/$1,000 Valuation $ $475 per SAC Unit $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Lo 4 . . K BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: Total Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. . . A SUBJECT ER City of Fridley 18 825 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT O. COMMUNITY DEVELOPMENT DIV. r y PROTECTIVE INSPECTION SEC. p r7 NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 IL'"'"1 / 612-571-3450 91 o-F15 3/19/87 JOB ADDRESS 5849 Washington Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 14 1 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Bernstein 5849 Washington Street N.E. 571-0623 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jerry Thell Builder 18020 Crocus Street N.W., Anoka 753-3064 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 2514" x 14` Three Season Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS Install products of combustion fire alarms in basement and in hall leading to bedrooms. This porch can not be heated except with a wood burner unless it were to meet the State Energy Code. WA Debre digging call `lod'al utilities SEPARATE TELEPHONE e ELECTRIC n GAS Etc, PERMITS RE WIRING; :^: i � GQUIRED FOR PLUMBING REQUIRED Y' LAW ,� , AND SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE $7,400 $3.70 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF AOPERMIDT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $68.50 OR THE PERFORM N E OF O TRUCTION. PLAN CHECK FEE TOTAL FEE $17.13 $89.23 URE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI s - WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT qA e if BLDG INSP _�ee nA SIGNATURE OF OWNER OF OWNER BUILDERI (DATEI NEW [ City of Fridley ADDN. R-1 AND R-2 ALTER. J Building Permit Application n Construction Address: 7 7 Legal Description: �—o Owner Name & ress : S' Contractor: Address :L—!� '7` Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. n DESCRIPTION OF IMPROVEMENT LIVJNG-A-REA: Length ' Effective 4/1/86 Tel. ,# =� - 06o23 Tel. # 3":: 71110, Width Height Sq. Ft._ GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Approx. Completion Date: Estimated Cost: $ �7 --,(C) CD Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: "% APPLICANT: Tel. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 Per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TO $ t`� STIPULATION ® 19 R BUMDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit:. Total Valuation . Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. s s . SUBJECT City ®f Fridley 2 6 5 6 % WI AT THE TOP OF THE TNS BUILDING PERMIT r o COMMUNITY DEVELOPMENT DIV. _ a. PROTECTIVE INSPECTION SEC. r _ NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ti____ll•' '•� 612-571-3450 910-F15 7-13-98 JOB ADDRESS 5849 NE Washington St 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 1 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bernstein 571-0623 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Erick W. Kallerup, 7400 1st Ave S., Richfield 55423, 798-1647, 7591 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION jD REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Re-roof house & garage (24 Sq) - tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,000 $1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $62,25 Fire SC$2.0 STRUCTI OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE License$5.0 _SjSIGNATURE TOTAL F E $70.25 OF CONTRACTOR OR AUTHORIZED AGENT (DATEIP PER LIDAT IS IS YOUR PERMIT ' .r► I 0 4 BLD SP nATE SIGNATURE OF OWNER IIF OWNER BUILDER] (DATEI s s . NEW [ l ADDN [ J ALTER [ l ConstructionAddres s : Legal Description: Owner Name & Address: Contractor: C 6'1 cl< Address: CITY, OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION r 1j F- LoQ Effective 1/1/98 r V1 S �_- C-_� !:� Tel. # -5 7 1 MN LICENSE # 7 S Tel. # 7 X19 ` `C W 7 Attach to this application, a Certificate of Survey of the ��� lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT LIVING AREA: Length Width Height Sq. FL GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Width Hgt/Ground S Ft. OTHER: Construction Type: T cak ® �OiC�reCEstimated Cost: $v (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: ( APPLICANT: Tel. # 720l STIPULATIONS: CITY USE ONLY Permit Fee $ S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,00 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 4!! $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ J TOTAL $ STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS : 5849 WASHINGTON ST NE PIN : 233024130093 LEGAL DESC : LYNDALE BUILDERS 7TH ADD : LOT 14 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION i PERMIT N .: 2004-008 DATE ISSUED: 06/08/2004 ' , VALUATION : $ 4,800.00 NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, LENNOX, 66,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES # GAS DRYERS APPLICANT GOLDEN VALLEY HEATING & AIR 5182 W BROADWAY CRYSTAL, MN 55429-3591 (763)535-2000 OWNER BERNSTEIN JAMES J & ARLENE 5849 WASHINGTON ST NE FRIDLEY, MN 55432 0 # GAS RANGES AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel t e provisions of any other state or local law regula ' g ' ns ion or the performance of construction. Annli,a t Date j Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS PIPING FEE GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 5321 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 0 0.00 35.00 10.00 0.00 0.00 25.00 0.50 70.50 CITY OF FRIDLEY BUILDING INSPECTION 61431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Fee Total Owner�_�Tlm $35.00 $ $10.00 $� Building Used ESTIMATED G Gas Range $10.00 $ DESCRIPTION OF FURNACE AND BURNER Water)EEAir) Gas Dryer $10.00 $ # of Heating Units ! Circle One (Steam) (Hot TradeNarng UU.i oy Size No. *Air Conditioning -All Sizes $25.00 $� BTU l 000 HP EDR� AtLiurcc ' Total Connected Load Fuel Qdd—, All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Burner Trade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/IndustriaVInstitutional and representations statJ9QM%&M%kLfQTM MrPect. QBA: GOLDEN VALLEY HEATING & AIR State Surcharge $ 150 HEATING C 5182 WEST BROADWAY CRYSTAL, MN 55429 TOTAL FEE 00,50 Signed 763.535•2000 Tel # `� 9 ((J X'/0 REINSPECTION FEE $50.00/HOUR FAX # l , _ ✓ Date *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the. venting has been examined and is free from rust, deterioration,, obstructions, and is securely supported andresto d where required. Yes ( No ( ) Lci t (l ta,V1 The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes W No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( ) No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type Mi -146 h e& t X K BTU Input310 Fan Assisted or Nat Appliance #2 Type t% r n ; BTU Input -� qan n Assiste rAppliance #3 Type BTU Input Assisted or Nat Total Appliances Total Btu Input 'h - B Common Vent Type Vent Height f 0 Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) 3 (, l f� at e'rJ k line HEATING CO: Signed By: Date : H USE HEATING TEST RECORD ADDRESS " 'v APT. FLOOR OCCUPP NT OWNER HEAT L8SS DATE HTG. INET. SOLD BY INSTALLED BY Electrical Work By ,�_ % Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. _ GAS DESIGN CONTROLS THERMOSTAT ASG 4.x.1 HEAT PLUG VALVE a®L LIMIT COMPANY TESTING LIMIT SETTING 200 FAN SETTING :1:10- Q PILOT TYPE S PILOT MAKE PILOT MODEL PILOT TIMING L.W. CUT OFF PRESSURE "�� PERCENT CO2 INPUT CFH PERCENT 02 STACK TEMP. % 2- PERCENT CO i FORM 235 MAKE OF BURNER MODEL MAX. BTU RATING MAKE OF FURNACE MODEL VENT SIZE CITY SUBUR�k4 UNIT HTR. OTHER CONVERSION KIND OF LINER SIZE NONE DRAFT HOOD y REGULATOR FILTERS SIZE NUMBER CHIMNEY LOCATION INSIDE OUTSIDE CHIMNEY CONSTRUCTION SMOKE BOMB WIRING DRAFT TEST TAG DOOR PRESSURE LIGHTING INST. DATE TESTED COMPANY TESTING r NAME OF TESTER CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAX: ( 7(33) 571-IZ57 ADDRESS 5849 WASHINGTON ST NE PIN 233024130093 LEGAL DESC LYNDALE BUILDERS 7TH ADD LOT 14 BLOCK I PERMIT TYPE ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-00923 DATE ISSUED: 06/16/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT GOLDEN VALLEY HEATING & AIR 5182 W BROADWAY CRYSTAL, MN 55429-3591 (763) 535-2000 OWNER BERNSTEIN JAMES J & ARLENE 5849 WASHINGTON ST NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 5327 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp. Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. v r . EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERM NO.: 2004-01688 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/28/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 5849 WASHINGTON ST NE PIN 233024130093 LEGAL DESC LYNDALE BUILDERS 7TH ADD LOT 14 BLOCK 1 PERMIT TYPE BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 4,789.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. ENCLOSE BACK CORNER UNDER EXISTING ROOF. STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 111.25 72.31 WAGENER CONSTRUCTION INC 20322148 7250 181 AVE NW FIRE SURCHARGE 4.79 RAMSEY, MN 5530 STATE SURCHARGE, VALUE 2.39 LICENSE SURCHARGE 5.00 TOTAL 195.74 PAID WITH CHECK # 4191 OWNER BERNSTEIN JAMES J & ARLENE 5849 WASHINGTON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the ovisions of any other state or local law regula ' n c ' erformance of cons n. Applicant Date as Bldg Insp Date v r . EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ j CITY OF FRIDLEY Effective 4/1/2004 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg In ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �16 ) 5714287 Fax BUILDING PERMIT APPLICATION B 4L Construction Address: <N� Vt 0-41s"5/pm Legal Description: Owner Name & Address: Contractor. Tel. # 1' 7/ -06'23 _ MN LICENSE # 20 -? U / V? S YJQ- Tel. # 6'/2 -3C —®4/v Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESC IPT N OF IMPROVEMENT LIVING AREA: Length `� • '� �� Width�l� Height Sq. Ft -1 GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER:��� Construction Type: ®_,:_A >�_ /%�c% Estimated Cost: $'771 76 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: a/ 2� `L_ APPLICANT: t Ddm �•- Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ Fee Schedule on Reverse Side F$`Z . 31 65% of Permit Fee $ � e !� .001 of Permit Valuation (1/10th%) $_:S9 $.50/$1,000 Valuation $ $1350 per SAC Unit $ _ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] TOTAL' $ STIPULATIONS: ® S (� 411. -4:-. M\'n 0 � 'JU I I 'i t m V. 1-01 7%1 1 i)L m V. im 1-01 im nisi AA -VAN" A01 nok J,06r y1a I 0 p 51 5 eA01r G's Je/l ;T cals f i- pley. NA►Lo 0 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS : 5849 WASHINGTON ST NE PIN : 233024130093 LEGAL DESC : LYNDALE BUILDERS 7TH ADD : LOT 14 BLOCK I PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01701 ,a 4 lzrl DATE ISSUED: 09/30/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. MOVE MAST AND WIRE ADDITION. 1;1 # 0-100 AMP CIRCUITS 2 APPLICANT HELGESON ELECTRIC INC 1691 BURNS AVE ST PAUL, MN 55106 - OWNER BERNSTEIN JAMES J & ARLENE 5849 WASHINGTON ST NE FRIDLEY, MN 55432 STATE SURCHARGE, ELEC FLAT 0.50 ELEC AMP SERVICE FEE 30.00 ELEC CIRCUIT FEE (0-100 AMPS) 12.00 TOTAL 42.50 PAID WITH CHECK # 3764 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.